VHD

Question 1

VHD stage: (+) risk, (-) symptoms, (-) severity

Answer 1

Stage A

Question 2

VHD stage: (+) risk, (-) symptom, mild-mod severity

Answer 2

Stage B

Question 3

VHD stage: (+) risk, (-) symptom, severe

Answer 3

Stage C

Question 4

VHD stage: (+) risk, (+) symptom, severe

Answer 4

Stage D

Question 5

Most common cause of AS

Answer 5

Degenerative calcification of aortic cusps

Question 6

Most common congenital defect

Answer 6

Bicuspid aortic valve

Question 7

Weak and late pulse in AS, low pitched midsystolic ejecttion murmur at 2nd R ICS

Answer 7

Pulsus parvus et tardus

Question 8

Should be used cautiously in AS pxs because of hypotension

Answer 8

ACEI / ARBs

Question 9

Intervention for AS

Answer 9

Transcatheter aortic valve implantation (TAVI), aortic valve replacement sx

Question 10

AS murmur transmitted to apex, resembling murmur of MR

Answer 10

Gallavardin effect

Question 11

AR murmur that is soft, low-picthed rumbling mid-to-late diastolic murmur, best heard in L lateral decubitus

Answer 11

Austin Flint murmur

Question 12

Jarring of the body and bobbing of the head w/ each systole in severe AR

Answer 12

De Musset sign

Question 13

Visible capillary pulsations at the root of the nail w/ pressure (seen in AR)

Answer 13

Quincke’s pulse

Question 14

Booming pistol shot sound over femoral arteries (seen in AR)

Answer 14

Traube sign

Question 15

To and from murmur when femoral artery is compressed (seen in AR)

Answer 15

Duroziez sign

Question 16

Bounding and forceful pulse, rapidly increasing and subsequently collapsing, appreciated in carotid and subclavian a.

Answer 16

Corrigan’s pulse

Question 17

AR murmur best appreciated when patient is:

Answer 17

Leaning forward, relaxed, appreciated in end-expiration

Question 18

Bounding pulse of the ulnar artery accentuated in

Answer 18

Watson’s water hammer pulse

Question 19

Decreased pulse pressure in AR

Answer 19

Heart failure

Question 20

Give a clinical finding in causes of AR

Answer 20

Endocarditis
Infective aortitis
Marfan's syndrome
Aortic dissection
RHD
Chronic/ severe HTN

Question 21

Typical ECG finding of AR

Answer 21

LVH with ST depression and T wave inversion in I, aVL, V5-6 (lateral leads)

Question 22

Tx for AR with CHF

Answer 22

ACEI and vasodilators

Question 23

Leading cause of MS

Answer 23

RHD

Question 24

PE of MS

Answer 24

Loud S1 and accentuated P2
Apical diastolic rumble and murmur
Opening snap

Question 25

ECG findings of MS

Answer 25

LAE, RAE, RVH; AF in severe cases

Question 26

Tx for MS

Answer 26

Beta-blockers, non-dihydropiridine CCBs, digoxin (rate control)
Warfarin (target INR 2-3) for stroke prevention

Question 27

PE of MR

Answer 27

Soft S1; S4 in acute severe MR
Apical holosystolic murmur radiating to axilla
Hyperdynamic LV w/ brisk systolicimpulse and laterally displaced apex beat